resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Spine Surgery: A Tale of Greed and Corruption
All too often, where there's substantial money to be made, greed and corruption inevitably follow.
We Get Letters & Email
In the Dec. 1, 2015 issue, we have Donald Petersen reporting on "the adapting chiropractic practice," which includes multidisciplinary practice as an option; a ChiroPoll indicating 59 percent of DCs are seeing at least 21 patients per day and 27 percent are seeing more than 40.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
The Future of Functional Neurology
Functional is the hot buzzword in health care these days; witness the rising popularity of functional medicine, functional testing and yes, functional neurology.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
News in Brief
A Winner in and Out of the Office; Ready for the "Have-A-Heart" Campaign? New Integrative Medicine Journal.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
The MRI: When and Why to Order One
As I lecture around the country to both chiropractors and medical specialists, it's clear one of the main disconnects between the two professions is that of an accurate diagnosis.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Preventing ACL Injuries in Female Athletes
For female athletes, the key to optimal athletic health lies in preventing ACL injuries. In medical terms, the anterior cruciate ligament (ACL) is the primary restraint to the anterior displacement of the tibia on the femur at all angles of the knee flexor.
Elevated Shoulder? Check the QL
As you know, posture reveals a great deal about the body. Posture is a unique mental and physical landscape revealing compensations and adaptations to life. It's a classic mind-and-body story.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Top 10 Fitness Trends for 2016
The American College of Sports Medicine (ACSM) published its annual fitness trend forecast in the November / December 2015 issue of ACSM's Health & Fitness Journal.
Do You Teach Patients How to Breathe Properly?
Spinal manipulation often produces quick results in terms of pain alleviation and improved range of motion. Unfortunately, once the patient is no longer in pain, they may discontinue therapy, only to be plagued by the same complaint at a future date.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
The Amazing Clinical Versatility of Milk Thistle (Part 1)
Most of us know that the standardized extract from the seeds of milk thistle (Silybum marianum) is probably the best-proven herb for protecting the liver from chemical and inflammatory damage.
Osteoporosis Isn't Always the Case
What is your diagnosis? The patient is a 58-year-old female with back pain. I am sure all of you see the compression fracture at L2; however, there are some findings that suggest this is not a compression fracture due to osteoporosis.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Sell Out: Using Research for the Wrong Reasons
The above chorus is from the ska band Reel Big Fish's 1997 hit song, "Sell Out," from their album, "Turn the Radio Off." In the song, the singer sarcastically relates the plight of a musician who is tired of "flipping burgers" and is willing to get "lots of money" by playing "what they want you to hear" in order to get a recording contract.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
July, 2008, Vol. 08, Issue 07
The Role of the Q Angle in Anterior Knee Pain
By Whitney Lowe, LMT
Postural distortions can lead to numerous soft-tissue disorders. Clients with these postural challenges often look to the massage therapist to help with the pain or biomechanical challenges that result.In the lower extremity, a large quadriceps angle, more commonly called the Q angle, is a postural distortion involving patellofemoral biomechanics. An exaggerated Q angle can lead to knee pain and knee pathologies, as well as compensations in other regions of the body.1
The degree of the Q angle is determined by measuring two lines superimposed on the lower extremity. One line begins at the tibial tuberosity and continues in a superior direction through the midpoint of the patella. A second line connects the anterior superior iliac spine (ASIS) with the midpoint of the patella. The angle between these two lines is the Q angle (Figure 1).
There is a disagreement in the research literature about what constitutes an exaggerated Q angle. Some sources say a Q angle as small as 10 degrees can be a problem, while others say it is not an issue until the angle is greater than 20 degrees.2 A challenge with evaluating the Q angle's role is it's not easy to accurately measure the angle. However, repeated investigations have shown people with a larger Q angle have a greater likelihood of developing numerous knee complaints.
To understand how the Q angle contributes to knee pathologies, it's helpful to look at the anatomical relationships in the region. The patella is embedded in the quadriceps tendon. There is a ridge on the underside of the patella that must fit in the trochlear groove between the two condyles of the femur (Figure 2). The patella moves superiorly and inferiorly in this groove during knee flexion and extension.
The patella's ability to track straight in the trochlear groove is determined by the quadriceps' angle of pull. When the Q angle is greater, the quadriceps pull the patella in a more lateral direction. The unequal pull on the patella causes increased tensile stress on soft tissues around the knee. Too much lateral pull on the patella also can drag it against the lateral femoral condyle and eventually cause degeneration of the cartilage on the underside of the patella - a condition known as chondromalacia patellae. Problems associated with the patella and its correct movement during flexion and extension are referred to as patellar tracking disorders. In addition to patellar tracking disorders, a larger Q angle also can be a major factor in patellar subluxation or dislocation, as well as anterior cruciate ligament sprains.
There is an increased incidence of these knee disorders in women and individuals with genu valgum. The Q angle is greater in women due to the wider pelvis, which places the ASIS farther away from the patellar midline, thereby increasing the Q angle. The Q angle also is greater in people who have the genu valgum postural distortion, more commonly known as knock-knees.
Because certain aspects of bony structure, such as a wide pelvis, determine the Q angle, it's difficult to alter the angle with soft-tissue work alone. However, treatments such as massage are helpful for addressing some of the factors that aggravate Q angle problems. For example, an imbalance in tightness between the vastus lateralis and vastus medialis muscles can contribute to patellar tracking disorders. If the vastus lateralis is too tight, it can pull the patella farther in a lateral direction. This situation often occurs in people with a larger Q angle. Comprehensive massage treatment of the vastus lateralis can reduce the distance it pulls the patella in a lateral direction.
There are numerous causes of anterior knee pain. Several of these can be related to an excessive Q angle. It's not necessary to pull out the protractor and determine the exact Q angle. However, a visual estimation of the Q angle can give important clues about the role this postural distortion plays in a variety of pain complaints. In those cases, massage treatment of the quadriceps muscle group and the retinacular fibers around the patella greatly helps reduce the detrimental results of a large Q angle.
Click here for more information about Whitney Lowe, LMT.
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